The Role of Psychosocial Factors in CRPS
Complex regional pain syndrome (CRPS) is a debilitating pain condition that is still relatively poorly understood by the medical community. The term “complex regional pain syndromes” came into use in 1995 and currently includes two major types: CRPS type 1 (formerly called “reflex sympathetic dystrophy”) and CRPS type 2 (formerly called “causalgia”). The hallmark clinical feature of CRPS is pain that is disproportionate to what would normally be expected in relation to a particular injury or insult. Although various criteria have been developed for the clinical diagnosis of CRPS, most experts agree that pain, swelling, color change, and decreased mobility of the affected limb are the most relevant diagnostic parameters. In general, treatment goals for CRPS include the relief of pain, which may be accomplished with medications or nerve blocks, and physical therapy and rehabilitation to improve function and quality of life.
Since the pathophysiology of CRPS is still not well understood, some doctors have long suspected that patients with CPRS may be predisposed to developing the condition due to underlying psychosocial factors. In recent years, there has been a considerable amount of research to determine whether CRPS patients may have predisposing personality or psychological traits that may make them more susceptible to developing this disorder. A recent study published in the Journal of Clinical Psychology Medical Settings examined the role of psychosocial factors in people with CRPS. After a detailed review of the relevant published medical literature, the authors of this study arrived at the following two major conclusions:
- Patients with CRPS do not appear to have any predisposing psychological or personality traits that would make them more susceptible to developing CRPS.
- Research, however, clearly supports the fact that CRPS results in serious psychological sequelae such as depression, anxiety, impaired quality of life, and functional/occupational disability for a subset of patients.
The clinical implications of these research findings are significant in terms of the approach for the management of patients with CRPS. The research strongly suggests that a multidisciplinary approach is critical for understanding and treating CRPS patients. Healthcare providers involved in the management of people with CRPS must develop a treatment plan whose goals include the dual objectives of addressing both the physical/medical aspects of the condition as well as the resulting psychological effects that may include depression, anxiety, and reduced quality of life. Moreover, early recognition and intervention is crucial for preventing both long-term physical and psychological complications of CRPS.
Reference: A review of psychosocial factors in complex regional pain syndrome. Journal of Clinical Psychology Medical Settings. Volume 20, pp. 247-254, 2013.
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